Position Summary: The Audit Specialist is responsible for managing the end-to-end process of responding to medical records requests, payor audits, and ensuring compliance with billing and documentation standards. This role involves reviewing, tracking, auditing, and submitting medical records, employee records, and company documents. The Audit Specialist will collaborate across departments to identify and resolve issues related to documentation, ensuring compliance with payor requirements, and implementing corrective actions as necessary. The ideal candidate will have experience in healthcare & ABA therapy, strong organizational skills, and familiarity with Salesforce or other EMR systems.
About Tidal Behavior Health Network: Tidal Behavioral Health oversees the operations of three ABA companies: Treetop ABA, Discovery ABA, and Little Leaf ABA. We provide services across more than 14 states and are committed to enhancing processes, elevating customer service, and delivering exceptional care for children with autism.
Key Responsibilities:
- Medical Records Management:
- Receive, track, and review all medical records requests from payors.
- Ensure timely and accurate responses to payor audits.
- Organize and manage all requested documents, including client, employee, and company records.
- Auditing & Compliance:
- Conduct detailed audits of medical records, employee records, and other company documentation to meet payor requirements.
- Identify discrepancies or documentation issues and collaborate with departments to resolve them.
- Ensure that all claims and services are fully supported by accurate documentation.
- Cross-Departmental Collaboration:
- Work closely with clinical, administrative, and billing teams to ensure the accuracy and completeness of required documents.
- Communicate effectively across departments to address any documentation issues related to audits and compliance.
- Corrective Action & Reporting:
- Identify areas where corrective action is needed and collaborate with internal teams to implement solutions.
- Track and document audit requests, outcomes, and corrective actions.
- Prepare detailed reports on audit findings and corrective actions for internal and external stakeholders.
- Continuous Improvement:
- Stay current with industry standards, payor requirements, and regulatory changes.
- Recommend and implement process improvements to streamline audit response procedures.
Qualifications:
- Education: Bachelor's degree in healthcare administration, business administration, or a related field preferred.
- Experience:
- 2+ years of experience in auditing, medical records management, or compliance within the healthcare or ABA industry.
- Familiarity with responding to payor audits and working in cross-departmental roles.
- Experience with Salesforce or other EMR systems is preferred.
- Skills:
- Strong organizational and project management skills.
- Ability to manage multiple tasks and meet deadlines.
- Excellent attention to detail and analytical skills.
- Strong communication and collaboration skills.
- Proficiency in Microsoft Office Suite, particularly Excel.
Benefits:
- Competitive Salary: Attractive compensation based on your experience and skills.
- Comprehensive Health Insurance: Medical, dental, and vision coverage for you and your family.
- Paid Time Off: Generous PTO to help you recharge and enjoy life outside of work.
- Remote Work: Enjoy the flexibility of working from home while living in or near Inwood, NY.
- Supportive Work Environment: Be part of a collaborative and inclusive team where growth and success are encouraged.
If you are ready to take on this impactful role and contribute to the success of our ABA programs, apply today!
Equal Opportunity Statement: Equal Opportunity Employer: The Treetop is an Equal Opportunity Employer. The Treetop is committed to providing equal employment opportunity for all, regardless of race, creed, color, religion, age, sex, sexual orientation, gender identity, marital status, citizenship, disability, military status, veteran status, national origin, ancestry, genetic information, or any other legally protected attribute. The Company encourages the hiring, promotion, training, and advancement of the best-qualified individuals available.
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